During total knee arthroplasty, portions of the patella, femur and/or tibia are replaced with artificial components. As part of this process, a proximal portion of the tibia and a distal portion of the femur may be resected. The proximal face of the resected tibia must then be prepared for receiving an implant. As part of this preparation, a keel punch can be used to prepare the tibial bone to receive an implant for implantation. The keel punch can be used to create a keeled or finned opening to accept the implant. The corresponding implant can then have a keel or fin shape that prevents rotation of the implant once it has been inserted into the opening.